The Pathway to Practice Training Programs

September 13, 2021

The COVID-19 pandemic has highlighted the nation’s impending physician shortage and the need to foster a more diverse physician workforce. As our population continues to grow and age, Congress must ensure that a well-equipped, culturally competent physician workforce can deliver high-quality care to all patients. We must significantly increase the number of Medicare-supported residency positions and increase the supply of underrepresented physicians.

GNYHA is grateful to the House Ways & Means Committee for including the Pathway to Practice Training Programs in budget reconciliation legislation. These programs would address health care provider shortages in rural and underserved areas, enhance graduate medical education (GME), and further diversify the physician workforce. 

The Pathway to Practice Training Programs are composed of two important policies: 

 Training Programs & Scholarships for Post Baccalaureate Students and Medical Students 

 The first program provides medical school scholarships to qualifying post-baccalaureate and medical students to increase the number of physician practicing in rural and underserved communities. The program would direct the Secretary of the Department of Health & Human Services (HHS) to award 1,000 scholarships per year starting in 2023. 

Eligible students for this program include first-generation college/post-secondary education students, Pell Grant recipients, and students who lived in a medically underserved, rural, or health professional shortage area (HPSA) for four or more years prior to attending an undergraduate program. Students enrolled in a post-baccalaureate program who intend to enroll in a qualifying medical school and students enrolled in medical school who will practice medicine in a HPSA, medically underserved area, public hospital, or rural area would also qualify. 

Qualifying students must agree to graduate from medical school (and post-baccalaureate program as applicable), complete an approved residency training program, and practice for at least one year per scholarship year in a HPSA, a medically underserved area, or a rural area. 

 Training Programs for Medical Residents

 The second program supports physician residency training in hospitals by providing 1,000 additional residency slots per year eligible for Medicare funding, beginning on October 1, 2026. During any one-year period, up to 1,000 additional residency slots could be provided under the program. The additional Medicare-funded residency slots would be awarded to hospitals that receive recognition under a new special status to be developed by the Accreditation Council for Graduate Medical Education (ACGME) for residency programs. The ACGME recognition status would be established and would operate separate from the Training Programs and Scholarships for Post-Baccalaureate Students and Medical Students. 

This new ACGME recognition status would be provided to hospitals for the sole purpose of demonstrating eligibility for the Medicare resident cap increases. Under the ACGME recognition program, hospital residency programs eligible for the additional residency slots would have to demonstrate that they are training residents in medically underserved areas, rural areas, or HPSAs and providing enhanced mentorship, structural and cultural competency training, and community-based training. 

In addition to strongly supporting the Pathway to Practice Training Programs, GNYHA urges Congress to further bolster GME by including the bipartisan, bicameral Resident Physician Shortage Reduction Act of 2021 (S. 834/H.R.2256) in reconciliation legislation. This important bill would add 14,000 new Medicare-supported residency positions, prioritize distributing the positions to underserved areas, and commission a report to explore ways to create a more diverse clinical workforce. These two bills would comprehensively address workforce shortages and ensure that the physician workforce can meet the nation’s health care needs. 

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